﻿<%@ Control Language="C#" AutoEventWireup="true" CodeBehind="USick.ascx.cs" Inherits="MaluJg.web.PovertyIn.USick" %>
<table border="0" cellspacing="0" cellpadding="0" class="FormTable tablefix" width="100%">
    <tr>
        <td class="FieldName">
            <span>&nbsp;姓名：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbName" Width="180px" runat="server" CssClass="InputSmall"></asp:TextBox>
            &nbsp; <span class="Alter">*</span><asp:RequiredFieldValidator ID="RequiredFieldValidator1"
                runat="server" ControlToValidate="tbName">必填</asp:RequiredFieldValidator>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;性别：</span>
        </td>
        <td class="FieldInput">
            <asp:DropDownList runat="server" ID="ddlGendar">
                <asp:ListItem Selected="True" Value="男" Text="男"></asp:ListItem>
                <asp:ListItem Value="女" Text="女"></asp:ListItem>
            </asp:DropDownList>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;年龄：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbAge" Width="180px" runat="server" CssClass="InputSmall"></asp:TextBox>
            <asp:RegularExpressionValidator ID="RegularExpressionValidator5" runat="server" ErrorMessage="非数字"
                ValidationExpression="^\d+(\.\d+)?$" ControlToValidate="tbAge"></asp:RegularExpressionValidator>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;村：</span>
        </td>
        <td class="FieldInput">
            <asp:DropDownList runat="server" ID="ddlVillage">
            </asp:DropDownList>
            &nbsp; <span class="Alter">*</span><asp:RequiredFieldValidator ID="RequiredFieldValidator2"
                runat="server" ControlToValidate="ddlVillage">必填</asp:RequiredFieldValidator>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;所属单位：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbDept" runat="server" CssClass="InputSmall"></asp:TextBox>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;疾病名称：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbSickName" runat="server" CssClass="InputSmall"></asp:TextBox>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;年份：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbYear" onclick="WdatePicker({dateFmt:'yyyy'})" runat="server" CssClass="InputSmall"></asp:TextBox>
            <span class="Alter">*</span><asp:RequiredFieldValidator ID="RequiredFieldValidator3"
                runat="server" ControlToValidate="tbYear">必填</asp:RequiredFieldValidator>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;月份：</span>
        </td>
        <td class="FieldInput">
            <asp:DropDownList runat="server" ID="ddlMonth">
            </asp:DropDownList>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;家庭类型：</span>
        </td>
        <td class="FieldInput">
            <asp:RadioButtonList runat="server" ID="rblFamily" RepeatDirection="Horizontal">
                <asp:ListItem Text="城镇低收入" Value="城镇低收入" Selected="True"></asp:ListItem>
                <asp:ListItem Text="农村低收入" Value="农村低收入"></asp:ListItem>
            </asp:RadioButtonList>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;医保情况：</span>
        </td>
        <td class="FieldInput">
            <asp:RadioButtonList runat="server" ID="rblYiBao" RepeatDirection="Horizontal">
                <asp:ListItem Text="城镇医保" Value="城镇医保" Selected="True"></asp:ListItem>
                <asp:ListItem Text="合作医疗" Value="合作医疗"></asp:ListItem>
            </asp:RadioButtonList>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;申请金额(元)：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbAppliedMoney" Width="180px" runat="server" CssClass="InputSmall"></asp:TextBox>
            <asp:RegularExpressionValidator ID="RegularExpressionValidator3" runat="server" ErrorMessage="非数字"
                ValidationExpression="^\d+(\.\d+)?$" ControlToValidate="tbAppliedMoney"></asp:RegularExpressionValidator>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;区级救助：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbDistrict" Width="180px" runat="server" CssClass="InputSmall"></asp:TextBox>
            <asp:RegularExpressionValidator ID="RegularExpressionValidator4" runat="server" ErrorMessage="非数字"
                ValidationExpression="^\d+(\.\d+)?$" ControlToValidate="tbDistrict"></asp:RegularExpressionValidator>
        </td>
    </tr>
    <tr>
        <td class="FieldName">
            <span>&nbsp;镇级救助：</span>
        </td>
        <td class="FieldInput">
            <asp:TextBox ID="tbTown" Width="180px" runat="server" CssClass="InputSmall"></asp:TextBox>
            <asp:RegularExpressionValidator ID="RegularExpressionValidator1" runat="server" ErrorMessage="非数字"
                ValidationExpression="^\d+(\.\d+)?$" ControlToValidate="tbTown"></asp:RegularExpressionValidator>
        </td>
    </tr>
</table>
